Three years after the conclusion of Healthy People 2010, the United States still lacks a sustainable, evidence-based action plan and the necessary data to monitor and track progress in the reduction of health disparities. Although substantial improvements have been made in the health status of African Americans over the past 10 years in major health indicators such as overall mortality, heart disease, cancer, stroke diabetes, infant mortality, lead poisoning, gonorrhea and asthma, substantial racial disparities continue to persist.
In St. Louis, these health disparities are pronounced, with blacks having a higher death rate compared to whites in almost every major health category, including heart disease, HIV/AIDs, diabetes and all cancers. A recent St. Louis Regional Health Commission study indicates that black children are approximately seven times more likely to visit the emergency room for asthma than white children.
Few would dispute the existence of health disparities; however, there is disagreement at the national, state, and local level concerning how successful we have been at reducing and eliminating health disparities.
Leaders from Missouri, Kansas, Nebraska and Iowa have come together to form the Heartland Regional Health Equity Council (Heartland RHEC), working toward a collective vision of a region without inequities in health and health care. This effort is a part of the National Partnership for Action to End Health Disparities throughout the United States.
In order to tackle the lofty goal of eliminating regional health and health care disparities, our council has been strategically mapping needs, gathering localized data, and will use this data to identify a targeted set of priority areas. We have completed the first step by developing a Blueprint for Action, which includes broad state and regional-level data and proposes a series of key products, including an environmental scan of local data, to guide our path forward. This Blueprint is based on research, and the environmental scan will enliven the research by refining data and identifying the specific issues that the Heartland RHEC intends to tackle.
The Blueprint for Action lays groundwork for our council’s work, which will:
Fulfill the need for local-level health data focused on minority groups. The Heartland RHEC is collecting quality data on hard-to-reach populations. The process has allowed for local feedback on how data is collected – including variables in data sets and how the data is housed – which is not typically considered. You may see our group in your community gathering information over the upcoming months.
Adopt a collaborative process. In the past, the successful elimination of health disparities has been thwarted by many well intentioned entities working on the same issue while competing for resources, study participants, and political capital. The Heartland RHEC will work with various organizations and entities including state, county, and local government, academia, private and public organizations, and various faith groups that all prioritize one goal – the elimination of health disparities.
Inform strategies in health care delivery, policies, and programs. The Blueprint for Action and environmental scan will identify key focus areas that we can tackle in order to ultimately end health disparities. These documents will serve as a foundation to address health disparities in our region through social determinants of health including education, jobs, and housing. The Blueprint and environmental scan will also help to identify priority areas for future research and provide background data and justification for potential grants to support health disparities elimination.
Our council will be successful when we have identified and implemented strategies that allow everyone an equal opportunity to be healthy. With collaboration and a roadmap for moving forward, we hope to claim success at reducing and eliminating health disparities in the Heartland Region.
Melody S. Goodman, PhD, MS, is assistant professor of surgery in Public Health Sciences at the Washington University School of Medicine and Keith Elder, PhD, MPH, MPA, is associate professor and chair of the Department of Health Management & Policy for the College for Public Health & Social Justice at Saint Louis University.
